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1003027046
KEITH STANLEY MARTIN
MADERA, CA
NPI
1003027046
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCS 15670)
Enumeration Date
2007-05-24
Last Update Date
2007-07-08
Business Address
Mr. KEITH STANLEY MARTIN LCSW
9300 VALLEY CHILDRENS PL
MADERA, CA 93638-8761
Phone number: 558-353-3000
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Mailing Address
Mr. KEITH STANLEY MARTIN LCSW
4507 W. BERKELEY AVENUE
FRESNO, CA 93722
Phone number: 559-276-1251
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